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Clin Nurs Res. 2018 Sep;27(7):853-870. doi: 10.1177/1054773817713177. Epub 2017 Jun 13.

A Case Study: Seclusion and Restraint in Psychiatric Care.

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1 University of Montreal, Qu├ębec, Canada.


A wide breadth of research has recognized that seclusion and restraint affects patients, staff, and organizations alike. Therefore, it is essential to understand the viewpoints of all stakeholders to improve practices. The study aimed to understand the context in which seclusion and restraint practices are employed based on the perceptions of staff and inpatients in a psychiatric ward. A case study was performed using a participatory approach. Methods included a 56-hr immersion in the practice setting and individual interviews with staff and patients ( n = 17). The main themes discussed were patient characteristics (etiology of the violence, difficult experience), staff characteristics (feelings of safety, rationalization of seclusion use), and environmental characteristics. Both explicit (e.g., hospital protocol) and implicit (e.g., ward rules) standards seem to influence seclusion and restraint management. Our results point toward the potential for developing post-seclusion and restraint review in which both patient and staff perspectives are taken into account.


aggression; case study; mental health; restraint; seclusion; violence


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